Doctor: Comparing hospitals would be unfair
enter their bloodstream and has the terrifying ability to transfer its resistance to other germs. ‘Reputation cost’
The state Health Department denied a public records request by the newspaper for the lab data, saying it is confidential and currently being analyzed for a report to be released to physicians this summer. It’s unknown whether the report will include provider information to show the medical facilities, nursing homes or even doctor offices where these super germs have surfaced.
McDonald said hospitals are well aware of the “reputation cost” of these germs and do not want to have the honor of having the highest rate of super- germ infection. “What happens is that people don’t want to keep going to that hospital and bringing them their business,” he said. “So there is a future cost there.”
CMS can withhold payment for certain performance-based care. In 2017, C. difficile infection rates will be tied to payments to hospitals and medical facilities. “It’s a small portion of overall payments but it’s enough that hospitals are paying attention,” he said.
Dr. Larry Bush, an infectious disease specialist practicing at Wellington Regional Medical Center said it’s unfair to look at infection rates at hospitals because the best facilities get the most acute cases and those are the patients, often long-term, who are especially susceptible to these super germs.
“It’s not comparing apples-to-apples when you are comparing hospital infectious rates,” he said. “It may keep you away from a better hospital.”
Bush said improper use of antibiotics is a big reason for the rise of the superbugs. The CDC says one study shows a 30 percent cut in the use of antibiotics resulted in significant decline in C. difficile.
The hospitals are quick to isolate patients even suspected of having one of these germs but he warned these microorganisms are not going away any time soon. Hospitals are fighting the good fight, but the germs can be contracted at offices of general practitioners and even the dentist, the CDC study notes.
“They outnumber us,” Bush said. “They were here before us and they will be here after us.”
The Florida Hospital Association said medical facilities are doing more. Martha DeCastro, president of nursing with FHA, said the more the medical profession learns about these organisms, the better they are at putting procedures in place to diagnosis patients and to stop outbreaks at the source.
“Huge progress has been made in the last 10 years — huge progress, but nobody is thinking, ‘Let’s sit back; we’ve done enough,’ ” DeCastro said. “We don’t want to have people afraid. We want people to have confidence.” VA team fights germs
The Veterans Affairs Medical Center in West Palm Beach said it has hired a team of specialists to combat super germs and to make sure scopes are clean of pathogens.
But the enemy is a moving target.
“The bug of concern has switched from MRSA to these other super bugs,” said Cindy Lang, senior infection preventionist with the VA in West Palm Beach.
The Post last week reported about a Gulf War veteran who claimed she got C. difficile after undergoing a preventative endoscopy and colonoscopy at the VA facilit y.
Mary Ann Goodman, for the VA Medical Center, said she was prohibited about addressing any particular patient case but said C. difficile, unlike some other super germs, is unlikely to be transmitted by scopes. Risks usually associated with C. difficile are antibiotic usage, GI surgery and a history of GI problems. Advanced age is also a factor.
Infection Control is a priority at the VA since a much-publicized scandal in which other VA hospitals transmitted hepatitis and HIV to patients through colonoscopies. The VA now goes beyond the CDC recommendations by using a microbial monitoring system that can spot supergerms after a multistaged high level disinfectant cleaning.
“The VA is the industry leader in prevention of C. difficile and other super bugs,” Lang said. “Other facilities want to know what the VA is doing as far reprocessing reusable medical equipment.”
Sometimes it’s the simplest of measures that do the trick, such as telling staffers to make sure they use soap instead of alcohol-based cleaners to wash their hands because alcohol doesn’t kill C. difficile spores, Lang said.
But when it comes to C. difficile, the CDC’s new study paints a scary picture.
The new study found 500,000 Americans suffer from C. difficile in a single year and that more than 100,000 of those infections developed among residents of U.S. nursing homes. It also concluded that 1 out of every 9 patients aged 65 or older who contracted the bacterium at a medical facilit y died within 30 days of diagnosis. The CDC said a separate study found that 82 percent of patients with C. difficile infections reported exposure not at hospitals but at doctor’s and dentist offices.
Those afflicted with C. difficile repeatedly swear by the fecal implant, an eye-raising procedure with fantastic results.
Morris, the Jupiter woman, credits Dr. Lawrence Fiedler at Boca Raton Regional Hospital in performing the implant and saving her life, saying she saw results within 24 hours. The donor for the implant was her adult granddaughter. Morris wanted to come forward to encourage others with C. difficile to get fecal implants.
“Do you want to live or do you want to die? This year I’m on a tennis team and playing all over the county and doing quite well,” she said. “Last year, I couldn’t get out of my bed. It’s like it has given me my whole life back.”
More than 500,000 Americans are infected each year.
29,000 patients die directly or indirectly each year from C. difficile.
More than 100,000 infections developed among residents of U.S. nursing homes.
1 in 5 patients will experience a recurrence of the infection.
More than 80 percent of the deaths associated with bacteria occurred among Americans aged 65 years or older.
1 in 9 patients older than 65 will die within 30 days of diagnosis of health care-associated infection.
C. difficile costs up to $4.8 billion each year in excess health care costs for acute care facilities alone.